Hi. I've been doing HH for a few weeks...had some classroom orientation, a week of shadowing and then out on my own. I have come home each night and burst into tears. I feel so responsible for these poor little people at home. One lady had such a heap of pills on her counter. I was supposed to do a med prefill. She had some in bottles, some on cards left over from the nursing home...a note from the nurse who admitted her that her doc said it was okay for her to use up the bottles before she got the scripts refilled. I could only fill 4 or was it 5 days worth of meds because she only had 5 days worth of one med...none of another. She said her daughter was going to bring it sometime...and toprol xl 50mgs when the order was lopressor 25. So she tells me 'they' cut them. Hmmm think I. The XL is long acting and the lopressor isn't but if 'they' do it I guess it's okay. I then went back to the office and thought better of it so I called a pharmacist and he told me that xl is long acting. So I called her house and spoke to her daughter. They had just gotten the lopressor script filled so I told the daughter to take the 1/2 tabs out of the pill box and use the 25s. I feel horrible that I made a mistake,even though she didn't take any of the pills.
I've been a nurse a long time....most of my career in LTC...management. I'm not sure I'm cut out for the lose environment of home care.
How long did it take all y'all to make the transition?
I'm supposed to meet with my team leader on Monday. What do I tell her? That I feel incompetent and am petrified I'll make a mistake?
I think it's time to give up nursing and do something else.
Hi CapeCodMermaid.....I just became a homecare nurse myself......I have dealt with homecare nurses for almost 18 years due to my daughter having home nursing care. Yes I know all too well about the whackos and people not doing their jobs.....bottom line is people just don't care anymore....not all but alot. They are just in it to collect a paycheck, and yes they do seem to get away with slacking off...but will be the 1st to complain about others.
The last HHA I worked for was filled with people who basically didn't give a flying damn, as LONG as they were able to write their own checks and schedules. It was a very toxic environment, propogated by a "good ol' boy" administration and a Director who was afraid of her own shadow. As soon as I discovered that my authority as a supervisor was being undermined, I left...and haven't looked back.
The last HHA I worked for was filled with people who basically didn't give a flying damn, as LONG as they were able to write their own checks and schedules. It was a very toxic environment, propogated by a "good ol' boy" administration and a Director who was afraid of her own shadow. As soon as I discovered that my authority as a supervisor was being undermined, I left...and haven't looked back.
Wow...thats awful! I hope they aren't all like that.....I have noticed though from my observation...I hope I am wrong.....that homecare nurses seem to get away with way more than they would if they worked in a facility...just from things I've seen personally in my own home....and it's almost like some of them think I am working for them as far as how they schedule their time and so forth......not all but a particular few I have had experiences with.
I hope I don't run into the nonsense with this on the cases I will be doing.....It just amazes me at some of the work ethics I have seen in my own home...let's just say I am far more dependable than some I have seen...& I am the one with a severly disabled child not them.......luckily I have gotten rid of alot of ya hoos in the past........
I hope you weren't one of those who turns a blind eye/deaf ear to things.....
Sorry you had such a horrible expoerience as a cm.... that stinks!
Specializes in Gerontology, Med surg, Home Health.
Ladies-
Thanks for all your replies and advice. I am settling in although slower than I'd like. I've been told I expect too much of everyone including myself. I just think that what we do as nurses, no matter where we work, is very important and we have to be ever vigilant so as not to screw up. OK .. off the soap box. I think it'll be easier for me when I have my own case load. Right now I only have 2 patients I see regularly. The rest are castoffs or overflow from other case managers. Seems I am always finding things that aren't straight forward. Was sent out today to do a microcoag. for PT INR for a post op hip. Got there, looked at the referral from the SNF and it said that yesterday was the last day for coumadin..That was on one page. On another page it said today was the last day. I called the ortho's office. It's now 4:40 PM and they still haven't returned my call. Whether she needed it or not, she took her coumadin this morning (don't ask) so I guess she's okay till tomorrow. That's what bothers me. Having left over things with out any resolution. The docs hardly ever call back and of course since she was in a SNF the past month, her PCP hasn't a clue what meds might have been changed.
I'm going to give it another few weeks and if I still feel scattered, I'll start looking for another job...or maybe take the summer off...paying bills is over rated!
You sound like me. You approach things that need follow-up like a persistent terrier (like a good nurse is supposed to do). You need to learn some relaxation techniques otherwise you will get an ulcer going or other physical symptoms. A good clinical supervisor/director will support you in your attempts to straighten things out, or you will be subject to subtle criticism for doing such a good job (and making other nurses' shortfalls show up). Just develop your own way of dealing with the job without letting it get to you. I always just did things, and never brought matters to the supervising personnel unless I got hauled in because another nurse complained because I did something. Just one of the pitfalls of home health. Unfortunately, you will find that here and there, home health hides a nurse who does not like to put out effort and complains if someone else does. Just chalk up your efforts to taking care of the patient. The patient will provide you with your job satisfaction. I only urge you to give home health a fair chance before you look for another job. And yes, it is possible, that you might be able to find a better home health position with a better home health agency. Good luck in whatever your decisions are. I can already tell from your posts that you are adapting! I think you'll be ok!
CapeCodMermaid.....I wish alot more nurses were like you....I have seen great ones and ones who couldn't do anything right & made you wonder how they even got through nursing school...I have one nurse(30+yrs exp) who cares for my daughter..and has been here for 10 years as a nurse in my home. She is one nurse who is very on top of stuff like you. One thing she does that really amazes me is that when she calls a doctor, medical supply co, anything to do with my daughter medically, if they don't return her call within an hour or two, she is right back on the phone again and she is very good at how she approaches them, throwing in maybe they were busy & just accidently overlooked her etc.....and will get on their case if she needs to.......I have alot of respect for her because she is like that...she always tells me the squeeky wheel gets the oil and if you don't keep on them they won't care...and she is sooooo right! And she gets the most respect from these people because of it.....it makes me want to be like her as a nurse because I admire her so much in that aspect.......well I am glad to hear you are a little better about your cases than before.......you are still adjusting to your new routine........hope it works out for the best for you!
Specializes in LTC and Critical/Acute Care/Homehealth.
I have an interview this morning with a HH agency. I am trying to go from LTC to HH. Your questions and answers are extremely helpful for me at this time.
CseMgr1, ASN, RN
1,287 Posts
The last HHA I worked for was filled with people who basically didn't give a flying damn, as LONG as they were able to write their own checks and schedules. It was a very toxic environment, propogated by a "good ol' boy" administration and a Director who was afraid of her own shadow. As soon as I discovered that my authority as a supervisor was being undermined, I left...and haven't looked back.